中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (3): 408-412.doi: 10.3969/j.issn.2095-4344.2016.03.019

• 细胞外基质材料 extracellular matrix materials • 上一篇    下一篇

异种脱细胞真皮基质移植修复深度烧伤创面

潘南芳1，卓 金2，王 欣1   

  1. 海南省人民医院，1烧伤与皮肤修复外科， 2康复医学科，海南省海口市  570311
  • 收稿日期:2015-12-06 出版日期:2016-01-15 发布日期:2016-01-15
  • 作者简介:潘南芳，女，1978年生，海南省文昌市人，汉族，主管护理师，主要从事烧伤康复护理、慢性伤口护理研究。
  • 基金资助:
    海南省自然科学基金资助项目(80006)：异体脱细胞真皮复合移植深度烧伤创面临床应用研究

Heterogeneous decellularized dermal matrix graft repairs deep burn wounds 

Pan Nan-fang1, Zhuo Jin2, Wang Xin1   

  1. 1Department of Burns and Skin Repair Surgery, Hainan General Hospital, Haikou 570311, Hainan Province, China; 2Department of Rehabilitation Medicine, Hainan General Hospital, Haikou 570311, Hainan Province, China
  • Received:2015-12-06 Online:2016-01-15 Published:2016-01-15
  • About author:Pan Nan-fang, Nurse-in-charge, Department of Burns and Skin Repair Surgery, Hainan General Hospital, Haikou 570311, Hainan Province, China
  • Supported by:

     the Natural Science Foundation of Hainan Province of China, No. 80006

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295

被引次数

12

摘要：

文章快速阅读： 

文题释义：
脱细胞真皮基质：脱细胞真皮基质是近十年国内外兴起的一种新型组织代替物，这种基质是用物理、化学等方法将皮肤中的表皮层及细胞成分彻底去除，仅保留真皮中含胶原网架的细胞外基质而得到的，具有创面覆盖、组织缺损填充、引导组织再生和支架等作用。脱细胞真皮基质可较好地结合创面，刺激成纤维细胞迁移至创面，继而能保护创面，避免因暴露使创面加深，减轻感染，创造有利于上皮生长的环境。

深度烧伤：是指伤及真皮乳头层以下，残留部分网状层的烧伤，深度烧伤自然愈合后会遗留瘢痕，并由于瘢痕收缩引起局部功能障碍，为此对于功能康复的要求比较高。对于深度烧伤创面传统的手术方法是切削痂清除全部坏死与变性组织，进行植皮修复，但愈合后瘢痕挛缩程度较重。

 

背景：采用异种脱细胞真皮基质移植修复深度烧伤创面后要经过一段长时间的康复期，在此期间容易发生色素沉着、瘢痕挛缩、容貌受损、功能障碍等并发症，因此对于术后功能康复的要求也比较高。
目的：探讨采用异种脱细胞真皮基质移植修复深度烧伤创面后进行功能康复锻炼的作用。
方法：将72例深Ⅱ度烧伤患者随机分为治疗组与对照组，每组36例，两组均给予异种脱细胞真皮基质移植治疗，从治疗后当天开始，治疗组接受积极的功能康复锻炼，对照组仅接受心理评估和数据收集。功能康复锻炼2个月后，对比两组真皮肿胀程度、疼痛、血清炎症因子水平及生活质量评估结果。
结果与结论：两组真皮肿胀程度比较差异无显著性意义(P > 0.05)；治疗组疼痛程度、肿瘤坏死因子α、白细胞介素6水平明显低于对照组(P < 0.05)，生活质量评估各维度评分均高于对照组(P < 0.05)，表明采用异种脱细胞真皮基质移植修复深度烧伤创面后进行功能康复锻炼，可缓解疼痛、抑制炎症反应、促进患者机体功能的恢复。 
ORCID: 0000-0002-0057-3672(潘南芳)

关键词: 生物材料, 材料相容性, 细胞外基质材料, 异种脱细胞真皮基质, 深度烧伤, 功能康复, 炎症因子, 生活质量, 海南省自然科学基金

Abstract:

BACKGROUND: Patients with deep burn wounds undergoing heterogeneous decellularized dermal matrix graft need to experience a long period of convalescence. During this period, patients are likely to develop pigmentation, scar contracture, looks damage, dysfunction and other complications, so there are relatively high requirements for postoperative functional rehabilitation.
OBJECTIVE: To discuss the role of functional rehabilitation exercises after the heterogeneous decellularized dermal matrix graft in repair of deep burn wounds.
METHODS: Totally 72 patients with deep II degree burn were randomly divided into treatment and control groups (n=36/group), and all subjected to heterogeneous decellularized dermal matrix graft treatment. At the day after treatment, patients in the treatment group were subjected to positively postoperative functional rehabilitation exercises; patients in the control group only received psychological assessment and data collection. After 2 months of functional rehabilitation exercises, the assessment results on degree of dermal swelling, pain, serum levels of inflammatory cytokines and quality of life of patients in these two groups were compared.
RESULTS AND CONCLUSION: There was no significant difference in the degree of dermal swelling of patients between these two groups (P > 0.05). The degree of pain, levels of tumor necrosis factor α and interleukin-6 levels were significantly lower in the treatment group than in the control group (P < 0.05), and the scores of each dimension were significantly higher than in the control group (P < 0.05). These results demonstrate that postoperative functional rehabilitation exercises after the heterogeneous decellularized dermal matrix graft in repair of deep burn wounds can relieve pain, inhibit inflammatory reactions and promote the recovery of the patient’s body function.